Large bone void in your tibial plateau fracture?
How to fill the defect so the joint surface holds. Fracture repair guidance for Bon Secours Mercy Health, OH.
You elevated the tibial plateau and now there's a gap under the joint surface. If it isn't packed well, the plateau can sink. You need a graft that resists compression and stays in place. Bon Secours Mercy Health surgeons face this in high-energy fractures from falls and motor vehicle crashes.
When a tibial plateau fracture is depressed, the bone under the joint surface is crushed. After you reduce the fragments, a void remains. That void must be filled or the joint surface can collapse under weight. Bone graft substitutes give new bone a scaffold to grow across the gap. The graft must resist compression from the femoral condyle above.
The size of the defect and the quality of the surrounding bone drive the choice. For large voids, a moldable, high-porosity graft like ALTAPORE SHAPE packs into irregular spaces and stays put. For smaller subchondral gaps, a flowable graft delivered by syringe fills completely without dead space. Cost depends on graft volume and the fixation used. Grafts are used with plates and screws, never alone.
This week, review your fixation plan and choose a graft that matches the void. If the defect is large and irregular, consider a moldable graft. If it is a small subchondral gap, a flowable graft may be better. Elite Surgical can bring samples and clinical data to your next case in Bon Secours Mercy Health. Ask your rep for a product in-service before the surgery.
After surgery, the graft supports the joint surface while new bone grows into it. Over weeks, the graft is replaced by living bone. The plateau stays elevated and the patient can start protected weight bearing as your protocol allows. The goal is a joint surface that does not settle.
Other things people in Bon Secours Mercy Health ask
weight bearing after tibial plateau fracture with synthetic bone graft
Weight bearing depends on the fixation, not the graft. The graft provides a scaffold for bone ingrowth but does not add immediate structural support. Follow your standard postoperative protocol for the plate and screws. Most patients stay non-weight-bearing for 8 to 12 weeks, with progression based on X-ray healing. The graft will remodel over that time; early loading does not speed it up.
how to choose bone graft substitute for distal radius fracture
Match the graft form to the void shape. For a small, contained cavity, a flowable graft in a syringe (like ACTIFUSE FLOW) fills every corner without overpacking. For a larger, uncontained defect, a moldable graft (like ACTIFUSE SHAPE) holds its form and does not migrate. If you need antibiotic delivery, ACTIFUSE ABX gives you enhanced handling plus the option to mix in powdered antibiotics. Avoid granules that can scatter into the joint.
cost of bone graft substitute for calcaneus fracture
Calcaneus fractures often need 5cc to 10cc of graft. Price it by volume, not by level. Synthetic grafts like ACTIFUSE are priced per cc. Ask your rep for a per-case cost breakdown that includes the delivery system. Compare that to the cost of a second surgery if the void is left unfilled or collapses.
synthetic bone graft safe open fracture
Synthetic grafts like ACTIFUSE are inorganic and do not provide a food source for bacteria the way allograft can. They can be used in a contaminated field after thorough debridement and irrigation. Many surgeons place the graft at the index procedure to maintain space and deliver local antibiotics mixed into the graft. If there is gross purulence, stage the grafting for a second look 48 to 72 hours later.
ACTIFUSE FLOW vs ACTIFUSE SHAPE fracture
For narrow, deep voids where you need the graft to flow into crevices, use ACTIFUSE FLOW. Its syringe delivery lets you place it precisely without overpacking. For a wide, shallow defect that needs to hold its shape while you close, ACTIFUSE SHAPE molds to the cavity and stays in place. If the void is both deep and wide, start with FLOW to fill the bottom, then cap it with SHAPE.
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Elite Surgical handles fracture repair in Bon Secours Mercy Health and the area around it.